January 1, 2015/Nursing

Building a Culture of Innovation in Nursing

Strong foundation and infrastructure fuel creativity

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By ECNO K. Kelly Hancock, MSN, RN, NE-BC

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Nurses by nature are inquisitive – and, for good reason. Considering healthcare’s swift pace, ongoing advancements and ever-changing technology, the opportunity to ask questions, ponder processes or consider alternative ways of thinking is natural and necessary.

From a new technique to an assistive device, the daily practice of nursing regularly includes thinking creatively or ‘outside the box,’ as outcomes of patient care often depend on this fine-tuned skill.

All too often, we find this creative ingenuity undervalued and overlooked, as many within the nursing profession have the humble viewpoint of, “I’m just doing my job as best as possible.”

In reality, creative thinking and idea development are much more than job fulfillment. They are the first steps in bringing innovation to life. From optimizing patient care to improving safety and patient outcomes or simply creating efficiencies in day-to-day responsibilities and beyond, nursing innovations drive our profession forward.

Experts like Dr. Peter Senge, who is known for his work in organizational learning, suggest that innovation brings creativity to measurable outcomes, actions, products and processes. In our current climate of change where value-based care is pivotal, successful innovations in nursing are imperative to forward progress.

Recently, at the ANCC National Magnet Conference®, Cleveland Clinic’s Associate Chief Nursing Officer for Research and Innovation, Nancy Albert, PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, shared a very factual and straightforward statement that was repeated on Twitter and immediately spread throughout the social media channel. She said, “Innovation helps nursing make money and save money.”

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Building a foundation of innovation in nursing not only fuels growth and progression within the profession, it elevates nursing creativity and stimulates unique solutions to problems or issues. Ultimately, nursing innovations lead to new or improved resources that drive costs down and advance nursing care and optimal patient outcomes.

If you build it, they will come

While innovation in nursing is becoming more of a forethought than an afterthought, encouraging nurses to bring their ideas or innovations forward needs nurturing.

A large part of establishing a culture of innovation is building a strong foundation of values (trust and collaboration) and resources that encourage it – so caregivers are engaged and know that they work in an environment that appreciates their creativity and teamwork—both of which inspire innovations.

Our leadership team spent many hours creating an infrastructure that is supportive of nursing innovation. For the past several years, we have made nursing innovation a key strategic point of focus.

Foundationally, we enhanced key job responsibilities of our Office of Nursing Research and Innovation (led by Dr. Albert), including focus on ideation and innovation development. This team mentors nurses in cultivating ideas into innovations or inventions that facilitate evidence-based nursing practices and improve patient outcomes.

The team encourages idea and innovation development through various supportive means, including a 5-step model for innovation development, one-on-one mentoring, and ideation and prototyping workgroup sessions.

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We developed a website that provides general nursing innovation information, offers education and insight, highlights innovations awards and recognizes innovators. The website resources allow nurses to work independently on an innovation; as it includes a listing of internal and external resources and references.

As ideas mature into innovations and inventions, peer review is needed to provide an objective viewpoint on the worth and return on investment of novel solutions. We created a Nursing Institute Innovations Peer Review Committee that meets on a regular basis to review new innovations and provide feedback to innovators. Ten innovation experts from varying nursing and other fields participate.

Among other initiatives, the Office of Nursing Research and Innovation spearheads three nursing innovation programs:

Innovations Inventory: When a nurse implements a process or system as part of usual work that was successful in meeting desired outcomes, they are encouraged to submit their innovation for review and development. The innovator meets one-on-one with a mentor, who helps determine the next step for innovation development. It might be commercialization, copyright and publication so others can use the innovation in their practices, or widespread implementation. Twice a year, awards are given for the top submissions and recipients are publicly recognized.

Step Forward: Many nurses have ideas and are unsure what to do with them. Our “Step Forward” program assigns mentors to help the idea originator(s) cultivate the idea and learn of its viability by reviewing websites, U.S. patent office information and publications to learn if it is indeed novel and can be patented, trademarked or copyrighted. In some cases, the idea will be cultivated for internal use, which is very rewarding.

Ideas2Innovations (I2I): This program involves three nursing units at various Cleveland Clinic hospitals and gives nurses an opportunity to trial, test or evaluate new products, services, devices or tools on their nursing units. Nurses provide feedback on quality, usability, patient satisfaction, nurse/team satisfaction, and more. Nurses provide a summary of findings and help nursing leadership determine the worth of new solutions on the market or in development. In this way, purchasing decisions are made by end-users and novel approaches are tested in real-world environments.

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Realizing nursing innovation success

I’m pleased to say that in the three years we’ve had the Innovations Inventory initiative in place, we have received more than 75 nursing innovations. And, in less than one year of the Step Forward program, we’ve received 20 applications; many of which eventually led to invention applications for further refinement and development.

Annually, we offer a Nursing Innovation Summit, which is intended for nurses and other healthcare practitioners who are engaged in advancing nursing knowledge and innovative practices. At this one-day summit, nurses have an opportunity to collaborate with other innovators, hear stories about how other innovations were born and developed and learn more about the processes of moving innovations forward.

In October 2014, we held our second annual Summit, which focused on foundational knowledge that cultivates ideas into formal innovations. The event attracted nearly 200 attendees from inside and outside the Cleveland Clinic health system. We hosted a representative from NASA, nurse inventors who shared their personal innovations journeys and lessons learned, a patent attorney, and representatives from the international innovation design firm IDEO, who presented an interactive workshop about prototyping innovative ideas.

Additionally, Cleveland Clinic’s Chief Innovation Officer, Thomas Graham, MD, described how he generated and developed ideas that resulted in nearly 40 patents. Our nursing organization works as a close partner with Dr. Graham’s Cleveland Clinic Innovations, the commercialization arm of Cleveland Clinic.

From the past to the present and into the future

Throughout the years, nursing innovations have directly and indirectly advanced the nursing profession to where it is today. We need to continue to allow innovations in nursing to be fueled because a tomorrow without innovation would be a tomorrow that remains stagnant rather than progressive.

Building a culture of innovation in nursing does not happen over night. At Cleveland Clinic, our philosophy on innovations in nursing is one that regards all incoming ideas and innovations as potentially worthy and important. When the innovation fails to move forward, we teach nurses that failure is part of success. Oftentimes, it is failure that brings forward new, sustainable ideas. All ideas, in one way or another, have the ability to grow and develop.

Innovation is a grandiose thing. It gives us insight, shows us possibilities that once didn’t exist, opens the door to opportunity and brings value to healthcare delivery, outcomes, patient experience and the progression of nursing.

We are at a place in time where it’s all about high quality patient care at the right cost and nursing innovations – from nurses at the bedside to the leadership table, and new graduates to tenured veterans – can help take us where we need to be.

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